Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems
Thesis: S.M. in Technology and Policy, Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2015.
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| Format: | Thesis |
| Language: | eng |
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Massachusetts Institute of Technology
2015
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| Online Access: | http://hdl.handle.net/1721.1/98001 |
| _version_ | 1826200449153236992 |
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| author | Zhang, Biao, S.M. Massachusetts Institute of Technology |
| author2 | Stan N. Finkelstein and Jarrod Goentzel. |
| author_facet | Stan N. Finkelstein and Jarrod Goentzel. Zhang, Biao, S.M. Massachusetts Institute of Technology |
| author_sort | Zhang, Biao, S.M. Massachusetts Institute of Technology |
| collection | MIT |
| description | Thesis: S.M. in Technology and Policy, Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2015. |
| first_indexed | 2024-09-23T11:36:38Z |
| format | Thesis |
| id | mit-1721.1/98001 |
| institution | Massachusetts Institute of Technology |
| language | eng |
| last_indexed | 2024-09-23T11:36:38Z |
| publishDate | 2015 |
| publisher | Massachusetts Institute of Technology |
| record_format | dspace |
| spelling | mit-1721.1/980012019-04-11T13:22:15Z Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems Decision analysis of novel POC diagnostics for PNA : implementation in Developing countries with tiered healthcare systems Zhang, Biao, S.M. Massachusetts Institute of Technology Stan N. Finkelstein and Jarrod Goentzel. Massachusetts Institute of Technology. Technology and Policy Program. Massachusetts Institute of Technology. Engineering Systems Division. Massachusetts Institute of Technology. Technology and Policy Program. Engineering Systems Division. Technology and Policy Program. Thesis: S.M. in Technology and Policy, Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2015. Cataloged from PDF version of thesis. Includes bibliographical references (pages 94-99). Pediatric Pneumonia (PNA) is the single leading cause of death in children under five, accounting for 19% of all childhood deaths worldwide. Due to severe resource constraints on healthcare, the global burden of the disease in children is disproportionately shared by developing countries. In particular, India, having the highest incidence rate of PNA, accounts for more than 30% of the world's neonatal deaths from pneumonia every year. The three-tier referral systems, shared by many other developing countries, has introduced inefficiencies into delivering appropriate healthcare to patients in need. Point-of-care (POC) diagnostics is a type of tool used to assist physicians to make clinical decisions. Its key advantage include the quick turnaround of results, low cost and high diagnostic power could potentially improve India's pressing situation due to pneumonia. Since the disease progresses quickly in infants and babies and transportation of patients within the healthcare system is time consuming, POC diagnostic is crucial in lowering both the mortality of children with pneumonia and the cost of treating PNA. To this effect, we investigate the potential impact of POC diagnostics when implemented in a three-tier referral system. Using India as a case country, I construct a decision tree model that evaluates cost, mortality, and the combined cost-effectiveness in Tree-Age software as a framework which evaluates five implementation strategies of a POC diagnostic for PNA within the Indian public healthcare system. The strategies reflect various prescription decisions and referral patterns in current medical practice in India. I concluded that (1) the diagnostic will result in both higher cost and mortality in areas where the practice is to provide all patients antibiotics and thus not recommended, (2) the diagnostic is very likely to achieve lower cost and mortality when patients do not always receive antibiotics and sometimes are given only symptom-relieving drugs and thus recommended, (3) the diagnostic has great potential in generating savings by limiting patients from being transported to urban hospitals, (4) when dual diagnostic is employed combining POC diagnostics and X-ray, confirming positive cases from the diagnostic by X-ray results in lower cost and confirming negative cases results in lower mortality and (5) the diagnostic can save resources and benefit health outcomes and should be implemented in places where X-ray is not available. by Biao Zhang. S.M. in Technology and Policy 2015-07-31T19:13:26Z 2015-07-31T19:13:26Z 2015 2015 Thesis http://hdl.handle.net/1721.1/98001 914481706 eng M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission. http://dspace.mit.edu/handle/1721.1/7582 103 pages application/pdf d------ Massachusetts Institute of Technology |
| spellingShingle | Engineering Systems Division. Technology and Policy Program. Zhang, Biao, S.M. Massachusetts Institute of Technology Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title | Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title_full | Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title_fullStr | Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title_full_unstemmed | Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title_short | Decision analysis of novel point-of-care diagnostics for Pediatric Pneumonia : implementation in Developing countries with tiered healthcare systems |
| title_sort | decision analysis of novel point of care diagnostics for pediatric pneumonia implementation in developing countries with tiered healthcare systems |
| topic | Engineering Systems Division. Technology and Policy Program. |
| url | http://hdl.handle.net/1721.1/98001 |
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